초록접수 현황
| 20F-196 | 구연 발표 |
A case of Infected Left Atrial myxoma presenting no growth bacteria on blood cultures.
Shia Kim, Won kyung Pyo, Sung ho Jeong
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Purpose : It is clear that Infected myxoma is very infrequent, although cardiac myxoma is one of the most common benign cardiac tumor. Since nonspecific symptoms and signs may occur in up to 90% of cardiac myxomas, including myalgia, muscle weakness,and fever, the diagnosis of infected cardiac myxoma may be a challenge.
We report this rare case of infective cardiac myxoma, we could consider various ways for diagnosis, especially when the cultures from patient’s results negative bacteria, and no characteristic figures of pathology.
Methods : A 39-year-old woman presented to the Emergency department of the hospital with uncontrolled fever, chills and myalgia that had intermittent for the previous 5 months. There were not any growth bacteria on blood culture and urine culture. On CT, mass in the LA , abutting to the interatrial septum and myxoma most likely was found, and TTE (Echocardiography) identified a huge echogenic mass with stalk which has Mass irregular surface and hypermobile.
Results : Myxoma removal was performed using AESOP. The pathologic examination of excision confirmed a mass as a left atrial myxoma and Pan-bacterial PCR revealed Haemophilus parainfluenzae 99.87%.
Conclusion : It is not easy to assess infective cardiac myxoma as cause of unknown origin fever. Especially, the atypical presentation of infective cardiac myxoma in this case highlights the challanges in diagnosing patients with negative blood culture results. PCR is a reliable tool for diagnosis infective myxoma. Therefore, it is desirable that we should consider other various laboratory tests which provide evidence for diagnosis of infective cardiac myxoma.
We report this rare case of infective cardiac myxoma, we could consider various ways for diagnosis, especially when the cultures from patient’s results negative bacteria, and no characteristic figures of pathology.
Methods : A 39-year-old woman presented to the Emergency department of the hospital with uncontrolled fever, chills and myalgia that had intermittent for the previous 5 months. There were not any growth bacteria on blood culture and urine culture. On CT, mass in the LA , abutting to the interatrial septum and myxoma most likely was found, and TTE (Echocardiography) identified a huge echogenic mass with stalk which has Mass irregular surface and hypermobile.
Results : Myxoma removal was performed using AESOP. The pathologic examination of excision confirmed a mass as a left atrial myxoma and Pan-bacterial PCR revealed Haemophilus parainfluenzae 99.87%.
Conclusion : It is not easy to assess infective cardiac myxoma as cause of unknown origin fever. Especially, the atypical presentation of infective cardiac myxoma in this case highlights the challanges in diagnosing patients with negative blood culture results. PCR is a reliable tool for diagnosis infective myxoma. Therefore, it is desirable that we should consider other various laboratory tests which provide evidence for diagnosis of infective cardiac myxoma.
책임저자: Sung Ho Jeong
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
발표자: shia kim, E-mail : shiakim@naver.com